ECFMG Professionalism & Ethics 5 — Questions and Answers
Question 1: An ECFMG-certified physician learns that a medical school she attended has been found to have issued fraudulent degrees. She is not personally involved in the fraud. Her most appropriate action is to:
- Take no action since she is personally innocent
- Proactively disclose the situation to ECFMG and cooperate with any investigation (Correct answer)
- Quietly obtain verification from another school to replace her credentials
- Consult a lawyer and avoid contact with ECFMG until formally contacted
Correct answer: Proactively disclose the situation to ECFMG and cooperate with any investigation
ECFMG requires certificate holders to disclose material information affecting credential validity; proactive transparency supports professional integrity.
Question 2: A physician employed by a managed care organization is told to limit specialist referrals to reduce costs. When a patient clearly needs specialist care, the physician should:
- Follow the organization's policy to preserve the employment relationship
- Refer the patient and advocate for the policy to be changed through appropriate channels (Correct answer)
- Refer the patient privately without documenting to avoid organizational scrutiny
- Ask the patient to self-refer so the physician avoids policy violation
Correct answer: Refer the patient and advocate for the policy to be changed through appropriate channels
Patient welfare takes precedence over organizational cost-cutting; the physician should refer and advocate for system change through legitimate means.
Question 3: A physician overhears colleagues making racially discriminatory comments about a patient in the break room. According to professional ethics, the physician should:
- Ignore it since it occurred outside the clinical setting
- Address it directly with colleagues and, if behavior continues, report it (Correct answer)
- Report it immediately to administration without speaking to colleagues first
- Document the incident privately but take no action unless it affects patient care
Correct answer: Address it directly with colleagues and, if behavior continues, report it
Discriminatory attitudes toward patients compromise care and violate professional norms; direct engagement followed by escalation if needed is the appropriate response.
Question 4: During a clinical encounter, a physician realizes the patient's presenting symptoms could indicate intimate partner violence. The most appropriate initial response is to:
- Avoid the topic to maintain the patient's dignity
- Ask directly about safety in a private, non-judgmental setting (Correct answer)
- Immediately call law enforcement
- Document the suspicion and defer to a social worker without speaking to the patient
Correct answer: Ask directly about safety in a private, non-judgmental setting
Screening for intimate partner violence with a private, non-judgmental inquiry is both an ethical obligation and a recommended clinical practice.
Question 5: Which of the following actions best reflects the professional value of 'accountability' for an IMG physician?
- Attributing a diagnostic error to a nurse's documentation mistake
- Acknowledging a clinical mistake to the patient, apologizing, and reporting it through the hospital's error reporting system (Correct answer)
- Correcting the error quietly without informing the patient to avoid distress
- Consulting legal counsel before disclosing any error to the patient
Correct answer: Acknowledging a clinical mistake to the patient, apologizing, and reporting it through the hospital's error reporting system
Accountability requires transparent disclosure of medical errors to patients and reporting through appropriate systems to improve safety.
Question 6: A physician is treating an adolescent (age 15) who discloses consensual sexual activity and requests contraception without parental notification. In most U.S. states, the physician should:
- Refuse care and insist on parental consent
- Notify parents immediately as required by law
- Provide confidential contraceptive services as permitted under minor consent laws (Correct answer)
- Defer care until the patient turns 18
Correct answer: Provide confidential contraceptive services as permitted under minor consent laws
Most U.S. states grant minors the right to confidential contraceptive services; providing this care respects both legal rights and adolescent health needs.
Question 7: A pharmaceutical company offers to fund a physician's research in exchange for favorable mention of their drug in resulting publications. This arrangement most directly violates the principle of:
- Veracity only if the physician publishes false data
- Research integrity and transparency due to undisclosed conflict of interest (Correct answer)
- Non-maleficence since no patient is directly harmed
- Justice because funding is inequitably distributed
Correct answer: Research integrity and transparency due to undisclosed conflict of interest
Undisclosed financial relationships with industry create conflicts of interest that compromise scientific integrity and must be transparently disclosed.
ECFMG Professionalism & Ethics 5
An ECFMG-certified physician learns that a medical school she attended has been found to have issued fraudulent degrees.
She is not personally involved in the fraud.
Her most appropriate action is to: